Artikel
Routine analysis of secondary data for monitoring prescription quality
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Autoren
Veröffentlicht: | 30. September 2004 |
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Gliederung
Text
Context
Inappropriate use of drugs is common in ambulatory and hospital practice. A consequence of ignoring contra-indications and possible interactions are unnecessary costs. Electronic checking of routine therapy and treatment data is a promising way to identify these problems and a prerequisite of early intervention.
Aim of Study
The study explores the drug use before, during and three month after a hospital stay regarding indication, relative and absolute contra-indications and drug-drug interactions. An electronic analysis tool was used.
Material and Method
We analysed the medication and diagnosis data of 299 patients admitted between 2000 and 2001 to the surgical department of a hospital. Medication and case history as well as changes in the admission medication during the stay were documented per patient in a relational database. The analysis uses the standardized Structured Query Language. Implementation of the routines in the analysis of large routine datasets of the health insurances is possible, if linked prescription and diagnosis data is available.
Results
On average, patients were 72.5 years old and took 3.6 (±2.15), 5(±2.4) and 3.8(±3.1) drugs simultaneously before, during and after the hospital stay. Inappropriate drug use regarding approved age was found in 11.7% of the patients. Mainly affected drugs were digitalis glycosides, weak opioids and sexual steroids. Absolute contra-indications were found in 63 patients (21.9%), relative in 122 (40.5%). A total of 777 described drug interactions was found in this sample of patients. 59 potential serious drug interactions were identified in 51 patients (16.9%). The daily therapy costs (based on the DDD) were, on average, at 2.54€, 8.12€ and 2.89€, respectively.
Conclusion
Electronic routine data is suitable for identifying age related off-label-use as well as drug interactions. If diagnosis information is available, also relative and absolute contra-indications can be investigated. The presented method is suitable for routinely analysis of prescription data, especially if diagnosis and prescription data are linked as required in the future by the German law (GMG).
Conflicts of interest: None
Sponsors: None